Online Therapy Legal and Ethical Issues

Confidentiality

Therapists may have his or her license revoked for “Failure to maintain confidentiality, except as otherwise required or permitted by law, of all information that has been received from a client in confidence during the course of online treatment and all information about the client which is obtained from tests and other means.”

Solution

Maintain confidentiality in your practice whether your sessions take place online or in your office.   

Online Therapy confidentiality is two part.  The first part is how you maintain confidentiality in your practice in general.

The second part is how the technology you use maintains confidentiality.  

Therefore, beware of what platform you use to communicate with your clients online.   Make sure the platform you use is secure, and isn’t the target of breaches.  Make sure that the provider of an Online Therapy platform does not store communications between you and your clients.  MyTherapyNet.com does not store any of your communications on our servers, except for the “Ask a Question” functionality.  MyTherapyNet.com does not review the contents of any messages you send or receive through the MyTherapyNet.com system.

Payment For Referral 

Payment for Referral if choosing to be connected with an Online Therapy Company:  Paying, accepting, or soliciting any consideration, compensation, or remuneration, whether monetary or otherwise, for the referral of professional clients is considered unprofessional conduct. This type of payment is illegal.  

MyTherapyNet takes no fees for clients you receive through our system, making us one of the only Online Therapy companies that doesn’t put your license in jeopardy. 

Out-Of-State Therapy

Out-of-state therapy is a continued hot bed of debate.  First, familiarize yourself with the Practicing Out of State regulations of the state in which you are licensed.  Next, familiarize yourself with the Practicing Out of State regulations of the state in which your client resides.  Our recommendation is to act accordingly to both of those states’ regulations.

In addition consider the following points:

  1.     Proceed and defend as necessary that therapy takes place where the therapist practices.
  2.     Insurance companies cover liability for national online counseling.
  3.     Only see clients in the state in which you are licensed.
  4.     Provide other services, such as Life Coaching, to clients in states other than your licensed state.

Reporting Abuse

Known or Suspected Cases of Child Abuse

         Child Abuse and Neglect Reporting Act delineates the counselors “duty to report” in the event of information obtained within the context of psychotherapy that constitutes a known or suspected incident of child abuse. Part (b) states that a “health practitioner,”  “Shall report the known or suspected instance of child abuse to a child protective agency immediately or as soon as practically possible by telephone and shall prepare and send a written report thereof within 36 hours of receiving the information concerning the incident.”

Known or Suspected Cases of Dependent Adult/Elder Abuse

         According to the new definitions of “abuse,” as of January 1, 1999, W. & I. C. Section 15630 explains that a mandated reporter of dependent adult or elder abuse shall report the known or suspected instance of abuse by telephone immediately or as soon as possible, and by written report sent within two working days.

Handling Dangerous Client Situations 

Duty to Warn (Tarasoff)

         “If there is a duty to warn and protect under the limited circumstances specified above, the duty shall be discharged by the psychotherapist making reasonable efforts to communicate the threat to the victim or victims and to a law enforcement agency.”

This law does not exist in every state; therefore, this may not be a mandate for you to follow, if one of your online clients states a serious threat of harm to another.

Threats of Suicide

         The Bellah vs. Greenson case (1978) mandates that a therapist take reasonable steps to prevent a threatened suicide. “Reasonable steps” may or may not include a breach of confidence. In the event that a therapist does breach a client’s confidence, Ev. C 1024 would protect him or her in the event of civil liability.  This law does not exist in every state; therefore, this may not be a mandate for you to follow, if one of your online clients states a serious threat of harm to themselves.